Superb microvascular imaging (ultrasound)
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At the time the article was created Bálint Botz had no recorded disclosures.View Bálint Botz's current disclosures
Superb microvascular imaging (SMI) or microvascular flow imaging (MVI/MV-flow - the name varying by manufacturers) is a recently developed ultrasound imaging technique that aims to visualize low velocity and small diameter blood vessel flow. Unlike conventional color and power Doppler imaging, superb microvascular imaging can suppress noise caused by motion artifacts without removing the weak signal arising from small vessel blood flow, hence it achieves a greater sensitivity than those 1.
Superb microvascular imaging (similarly to power Doppler) typically displays a monochrome map of blood flow superimposed on the B-mode image, though some systems are now capable of providing color-coded directional information as well.
Due to the relative novelty of the superb microvascular imaging (SMI) technique, strong clinical evidence about its use is lacking. Existing research shows that it can be utilized to:
characterize focal and diffuse liver lesions
assess vascularity of cystic and solid renal lesions3,4
assess vascularity of breast masses5
evaluate thyroid nodules
Superb microvascular imaging also shows promise as an adjunctive tool in musculoskeletal ultrasound by allowing more sensitive detection of increased vascularity in tendons, joint capsules, and peripheral nerves. Some studies have also demonstrated its potential use in evaluating intraplaque neovascularization and thereby in assessing the risk of hemorrhage in carotid plaques 2.
Several similar but proprietary microvascular flow imaging methods have been developed by different manufacturers, thus a similar technique can be encountered under various names in the literature:
microvascular flow (MV-flow, Samsung Medison)
microvascular imaging (MVI, General Electric)
superb microvascular imaging (SMI, Canon Medical Systems)
Slow flow (Siemens Healthineers)
- 1. Artul S, Nseir W, Armaly Z, Soudack M. Superb Microvascular Imaging: Added Value and Novel Applications. (2017) Journal of clinical imaging science. 7: 45. doi:10.4103/jcis.JCIS_79_17 - Pubmed
- 2. Zhen‐zhen Jiang, Yan‐hua Huang, Hua‐liang Shen, Xia‐tian Liu. Clinical Applications of Superb Microvascular Imaging in the Liver, Breast, Thyroid, Skeletal Muscle, and Carotid Plaques. (2019) Journal of Ultrasound in Medicine. doi:10.1002/jum.15008 - Pubmed
- 3. Leong J, Wessner C, Kramer M et al. Superb Microvascular Imaging Improves Detection of Vascularity in Indeterminate Renal Masses. J Ultrasound Med. 2020;39(10):1947-55. doi:10.1002/jum.15299 - Pubmed
- 4. Járay Á, Farkas P, Semjén D, Battyáni I, Botz B. Additional Value of Microvascular Flow Imaging In the Assessment of Cystic and Solid Renal Lesions. Physiol Int. 2023. doi:10.1556/2060.2022.00133 - Pubmed
- 5. Xiao X, Chen X, Guan X, Wu H, Qin W, Luo B. Superb Microvascular Imaging in Diagnosis of Breast Lesions: A Comparative Study with Contrast-Enhanced Ultrasonographic Microvascular Imaging. Br J Radiol. 2016;89(1066):20160546. doi:10.1259/bjr.20160546 - Pubmed